| NPI | 1497360606 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LA2200X Nurse Practitioner Adult Health (Licence: IL 209.021575) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: IL 041.422552) |
| Enumeration Date | 2020-09-14 |
| Last Update Date | 2020-09-14 |